An erupting volcano is an apt description for the impending obesity and chronic non-communicable disease epidemic in Dominica.1
Obesity and its complications has certainly taken a toll on the health and wellness of the Caribbean community and our fragile health care systems. The goal of this article is to help elucidate some of the food policy changes that may be considered at the institutional and national level in order to combat the growing obesity epidemic.
Cardiovascular disease is the leading cause of morbidity and mortality in the Caribbean region and Dominica. In 2011, the World Bank reported that Dominica has the most obese population in the OECS and anticipates that by 2015, approximately one-third of men and two-thirds of women will be obese. 2 While adult obesity needs to be addressed, there is also growing concern for childhood obesity.
At the national level, food policy changes are needed to address the growing obesity epidemic, however, there is a lot that can be done by schools to address this problem. Why target schools? Our eating habits are formed in early childhood and adolescence. Furthermore 80 percent of children who are obese during their teen years grow into obese adults. 3 Obese children are the future diabetics and hypertensives.
1. I attended a high school in Dominica which allowed the sale of sodas daily to the students. Sugar sweetened beverages (which includes sodas and artificially sweetened juices are one of the main culprits of the obesity epidemic. Schools should prohibit the sale of sodas and other sugar sweetened beverages on their compounds and make water the beverage of choice.
2. Snacking options at my school included white bread or “Johnny cake”/bakes served with a hot dog or some other salted/potted meat or fish. This snack was never served with vegetables nor was I given the option to purchase fruit. Schools need to regulate the type of foods that their students are exposed to while at school. Schools may opt to make it a requirement that vendors offer water and fresh fruit and vegetable options.
3. Usually within 2-5 minutes’ walk from most schools across the island, there are usually a few shops which sell sodas, candies and salted snacks. Laws should be enacted to prevent the sale of these items to children in the school zones and encourage the sale of healthier options. When we speak of creating a healthy food environment, we simply mean to make the healthy option, the easy option.
4. Both my primary and secondary school limited “sports day” to a once weekly activity. Most children don’t get the recommended 60 minutes of daily physical activity. Their lives have also become increasingly sedentary while sitting watching various screens. Schools should consider making every day a “sports day” to increase physical activity among their students.
Barbados has recently imposed a 10% tax on sodas and other sugar sweetened beverages. Mexico, which was once the most obese nation in the world, has imposed a similar tax and has noted a reduction in soda consumption. There is evidence that taxing unhealthy foods/beverages can potentially reduce consumption.4 These taxes can be used to assist local farmers in their production of local foods or provide food subsides that will make locally grown fruits and vegetables more affordable for low-income families.
Legislation should also be enacted to prevent the marketing of unhealthy foods particularly “fast foods” to children. Conversely, there should be aggressive marketing of local fruits and vegetables. Meanwhile, ads should highlight the true health effects of consuming these unhealthy processed foods which include Diabetes (loss of vision, amputation and dialysis), High Blood pressure (Stroke and Heart Attack) and cancer.
As a region, we also need to address our perception of what constitutes a healthy weight. It is not surprising that twice as many women are obese as a larger physique is considered more desirable in the region. Regional women are also less physically active than men.2 Consequently, 51% of deaths attributable to cardiovascular disease and 61% of deaths due to cerebrovascular disease were women.2 Regionally, women will take appetite stimulants in order to gain weight in order to appear more attractive.
These recommendations are not new, most developed countries have failed to implement food policy changes due to a lack of political will and resistance from food manufacturers. Most Caribbean islands do not have a healthcare system that can manage the tsunami of chronic diseases and so changing the food landscape is our only option. Do we have the political will to make the decisions needed to curb the obesity epidemic?
Bibliography:
1. Dr. Carissa Etienne , Director , Pan- American Health Organization
2. World Bank-The growing burden of non-communicable diseases in the Eastern Caribbean.
3. Reducing Childhood Obesity Through Policy Change: Acting now to prevent obesity , 2010
4. Obesity 2; Smart Food Policies for Obesity Prevention
5. PAHO Health Statistics.
Lisa Jolly is a Dominican and family physician living in St. Croix.
I believe to that our schools need to encourage children to drink plenty water. The snacks are not the best but how do we get out children to drink the amount of glasses of water they need per day?
What is sold in DA for breakfast in 9 out of 10 restaurants in ROSEAU is FRY CHICKEN, BAKES AND COCA COLA for breakfast everyday..
I heard over the radio, “The medicine we need is not in our bathroom cabinet but in our kitchen cabinet.” Or we could say, in our kitchen.
Canned and packaged foods are not part of it.
Vegetables, fruits, bananas, herbs, garlic, onions, tomatoes, cucumber, sweet peppers, leafy green – lettuce, spinach and the list goes on. I love them all and eat them all.
I noted on a Website that bananas fall under the category of fruits.
It is really worth eating and drinking nutritiously.
Eating them and drinking ample water and milk daily, note the texture of the skin including on the face. The face has a shine, sparkle and youthful apperance.
Of course, it also comes from the heart for our faces are mirrors of our heart, what is contained in it. If a loving, kind and generous heart, this will be projected on the face.
I have previously stated, it is better to do good – far better and to generate it to all. We are the recipients of our actions, in words and deeds.
Would you believe it? I heard of this doctor last year. Some people who reside in St. Croix and attended their relative’s funeral mentioned her name during a conversation at the reception. I believe she is the doctor of one of them.
Her face looks familiar.
I was curious about her because I had not heard of her previously.
Thank you Dr. Lisa Jolly for your informative article which is greatly appreciated. I will ensure that others who may not have seen it will know of it.
I do hope those who read it and are especially in need of changing their lifestyle to a healthy one will take advantage of the information you provided.
It will also assist those who do their utmost to maintain a healthy lifestyle. It also serves as a reminder to care for our health and maintain good health.
Good health is important without which we are not able to live a normal life.
Thank you immensely! Healthy food and healthy eating are really our medicine.
Killing Fat Children=KFC has a big role in part of the obesity. Dominicans a lazier as well to cook.
I agree with all these suggestions! One of the biggest problems is culture. People believe that being fat is better than being healthy. I recently changed my diet and started exercising, and I lost weight, but my family is harassing me to regain the weight because they think I should be fatter to look my age.
Stick to your present weight and eating and drinking healthily
Your family need health education. I expect you will educate them accordingly.
Give them a copy of this article or ask them to read it.
I wish that food could be the medicine in DA. However, there is little organic available, much pesticide use, and junk import food. As well, too much reliance on starchy foods.
In bygone years Dominicans knew nothing about organic. Some lived to as much as one hundred years and over. A few died of old age.
They were slim. I suppose they did not indulge in drinking all these soft drinks.
Dominica did not have fast food outlets.
They ate three times a day.
The type of flour to make bread was white.
I believe eating in moderation.
Root vegetables and fruits are healthy.
My favorite soft drink is ginger ale or sprite especially when I socialize. If ginger ale is finished and sprite is available I will drink it
Water and homemade fruit juices are better. These do not have to be very cold.
Dr.Jolly thank you so much,our people are lost,propeer diet is the key,am 45 and still feel lie 21,over the years i have been very careful with my diet.When i do visit home so sad to see the obesity rate in once our lovely Dominica.
Also instead of having beauty pageants for miss “Bold & Beautiful” why don’t we have a pageant celebrating weight loss by these individuals.
I am sick of seeing these obese ladies wearing the tightest and shortest outfits, that’s just sick. now I fully understand that in certain cases genetics and health issues may play a prominent role in such obesity. I am not being a hater, I am looking at this from a health standpoint not aesthetics. Obese people are far more likely to have many health issues than the average sized person.
I expect to get some flack for my views but it is time that we call a spade a spade. I blame the men too. you should be encouraging your ladies to lead a healthy lifestyle instead of celebrating dat big booty!!!1!!
There is nothing wrong in having beauty pageants.
The problem through the years they did not have health information.
Thanks also to Internet we can also access vital health information.
They should not starve themselves; just cut down on how much and what they eat, drink and calories.
It goes both ways. Some men are not slim. Some have what we call a beer belly.
Men and women who are slim and hopefully healthy look well as they age.
Today, more people are health conscious.
Just asking? Where is our sweet, Nicki, and our Just. Dennis.??????
Admin: Just to assure you that their slots are always available whenever they choose to contribute.
Thanks, D. N. O. I will apply for some space soon. lol. Always.
Good to see overseas Dominicans still contributing to their homeland. Keep it up, Dr. Jolly
I was in Dominica last year and something that struck me were the number of people selling hotdogs on a stick. I had never seen this before.
There used to be a time when we, by necessity were more physically active. We did not have TVs and electronic gadgets to turn us into couch potatoes. We had to walk to get from point A to B.
Now our children spend their free time in front their computers, and instead of encouraging them to walk, the parents drive them everywhere.
With increased incomes, people do not want to cook as much local foods as our parents did. They prefer easy prepackaged and fast foods. That is the price we pay for development.
Don’t blame the technology. My line of work ensures that I spend most of my time at the computer but I exercise alot. We have to change our culture to be one more concerned about health and physical fitness. While people are blaming technology for the reduction in daily physical activity people who are way more into the tech industry are the ones who stress more on the importance physical activity. It’s a problem of education and awareness and this article does a really good job at providing vital information. Sadly most won’t read this because it’s not something about demons or politics.